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PSOM treatment

I have a bitch with a hard grade of PSOM (but SM free). Last months I've seen her wagging tale have disappeared more and more together with her hearing ability, so it's time to do something now. Her half-sibling have the same problem (not owned by me), and got a myringotomy 2 years ago, and she've been treated with prednisolone and antiinflammatory after that. Both giving her a foul coat, and doesn't stop her from scratching.

My girl doesn't scratch, but she's rubbing her ears against everything (especially hard rocks outside!), and are helding her head quite low when taking a walk. I want to keep away from prednisolone/cortisone for what it's worth, so I have been looking outside the box.

3 years ago there was a post in here about using Acetylcystein to thin out the mucus so it could drain easier - and I hope someone here have gotten a better image of how it works after these years? Any progression? And if someone have experience with this, did you do a myringotomy before the Acetylcystein-treatment?

I am sorry I don't have an answer but I really am interested in the answer to your question. My dog Winston just went through the decompression surgery for CM & SM. He also has PSOM & I would prefer not to put him through more surgery right now.